Six-minute walking test performance is associated with survival in cirrhotic patients

BACKGROUND Patients with cirrhosis are at risk of cirrhotic cardiomyopathy,with resulting cardiac dysfunction and exercise limitations.Six minute walking test(6MWT)assesses functional status and predicts morbidity and mortality in cardiopulmonary diseases.AIM To determine if it associates with mortality by analyzing 6MWT performance in patients with liver cirrhosis.METHODS A cohort of 106 cirrhotic patients was evaluated in the outpatient setting with echocardiogram and 6MWT and follow up for one year to document hepatic decompensation and mortality.The distance in meters was recorded at the end of 6 min(6MWD).RESULTS This cohort had a mean age of 51 years and 56%male;patients were staged as Child A in 21.7%,B 66%and C 12.3%.Walk distance inversely correlated with Child scores,and was significantly reduced as Child stages progresses.Patients who died(10.4%)showed shorter mean 6MWD(P=0.006).Low 6MWD was an independent predictor of mortality(P=0.01).CONCLUSION 6MWT is a noninvasive inexpensive test whose result is related to Child scores and mortality.It is useful to identify patients with liver cirrhosis at high risk of mortality for closer monitoring and potential early intervention.

Reply to"Six-minute walking test performance is associated with survival in cirrhotic patients"to the editor

Use of the six-minute walk test has been proposed as a prognostic marker in liver cirrhosis.In the Letter to the Editor presented here,the authors highlight some important points,which were raised after the article was published in the November issue of the World Journal of Hepatology.

Effects of a Graded Brisk Walking Test with Different Intensity Levels on Elderly Patients with Essential Hypertension:A Prospective Study in Shanghai,China

Background:This study aimed to clarify the effects of a Graded Brisk Walking Test(GBWT)program on blood pressure(BP)control in elderly patients with essential hypertension and to determine its appropriate degree of intensity for elderly people.Methods:In total,421 out of 620 participants were randomly sampled from a community health center in Shanghai,China.Among them,200 and 221 patients were assigned to the intervened and control groups,respectively.They were all treated with the GBWT program for 8 weeks,16 weeks,and 24 weeks.Results:Based on ANOVA,there was no significant time main effect,condition main effect,or time by condition interaction both in heart rate and body mass index indicators(P>0.05).There were significant condition main effects,time by condition interaction,or time main effects in blood pressure(F=21.875,33.457,65.342,respectively;All P<0.05).After the intervention,significant differences in systolic blood pressure(SBP)and diastolic blood pressure(DBP)values were also observed in the two groups(P<0.05);the average values of the baseline and second phases of the intervention group were significantly lower than those of the control group(P<0.05).Significant differences in blood pressure values after the first two phases were also observed when compared with those before the intervention.Similarly,a significant difference in the first phase and second phase was also found between the BP group and intervention group.However,after the third phase(24 weeks,high-intensity exercise),no significant differences existed both in SBP and DBP groups compared with those before the intervention(P=0.07).Conclusion:GBWT is an effective exercise prescription to mitigate the essential hypertension in elderly Chinese patients,and the intensity,walking distance,and target number of steps can be adjusted according to the age of the patients.

Correlation between the Six-Minute Walk Test and Subjective Functional Class in Patients with Heart Failure

Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.

An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

Six Minute Walk Test to assess functional capacity in chronic liver disease patients

AIM: To examine the utility of Six Minute Walk Test (6MWT) in patients with chronic liver disease (CLD). METHODS: Two hundred and fifty subjects between the ages of 18 and 80 (mean 47) years performed 6MWT and the Six Minute Walk Distance (6MWD) was measured. RESULTS: The subjects were categorized into four groups. Group A (n = 45) healthy subjects (control); group B (n = 49) chronic hepatitis B patients; group C (n = 54) chronic hepatitis C patients; group D (n = 98) liver cirrhosis patients. The four groups differed in terms of 6MWDs (P < 0.001). The longest distance walked was 421 ± 47 m by group A, then group B (390 ± 53 m), group C (357 ± 72 m) and group D (306 ± 111 m). The 6MWD correlated with age (r = -0.482, P < 0.01), hemoglobin (r = +0.373, P < 0.001) and albumin (r = +0.311, P < 0.001) levels. The Child-Pugh classification was negatively correlated with the 6MWD in cirrhosis (group D) patients (r = -0.328, P < 0.01). At the end of a 12 mo follow-up period, 15 of the 98 cirrhosis patients had died from disease complications. The 6MWD for the surviving cirrhotic patients was longer than for non-survivors (317 ± 101 vs 245 ± 145 m, P = 0.021; 95% CI 11-132). The 6MWD was found to be an independent predictor of survival (P = 0.024). CONCLUSION: 6MWT is a useful tool for assessing physical function in CLD patients. We suggest that 6MWD may serve as a prognostic indicator in patients with liver cirrhosis.

Retrospective study of effect of whole-body vibration training on balance and walking function in stroke patients

BACKGROUND Dysfunction in stroke patients has been a problem that we committed to solve and explore.Physical therapy has some effect to regain strength,balance,and coordination.However,it is not a complete cure,so we are trying to find more effective treatments.AIM To observe the effect of whole-body vibration training(WVT)on the recovery of balance and walking function in stroke patients,which could provide us some useful evidence for planning rehabilitation.METHODS The clinical data of 130 stroke participants who underwent conventional rehabilitation treatment in our hospital from January 2019 to August 2020 were retrospectively analyzed.The participants were divided into whole-body vibration training(WVT)group and non-WVT(NWVT)group according to whether they were given WVT.In the WVT group,routine rehabilitation therapy was combined with WVT by the Galileo Med L Plus vibration trainer at a frequency of 20 Hz and a vibration amplitude of 0+ACY-plusmn+ADs-5.2 mm,and in the NWVT group,routine rehabilitation therapy only was provided.The treatment course of the two groups was 4 wk.Before and after treatment,the Berg balance scale(BBS),3 m timed up-and-go test(TUGT),the maximum walking speed test(MWS),and upper limb functional reaching(FR)test were performed.RESULTS After 4 wk training,in both groups,the BBS score and the FR distance respectively increased to a certain amount(WVT=46.08±3.41 vs NWVT=40.22±3.75;WVT=20.48±2.23 vs NWVT=16.60±2.82),with P<0.05.Furthermore,in the WVT group,both BBS score and FR distance(BBS:18.32±2.18;FR:10.00±0.92)increased more than that in the NWVT group(BBS:13.29±1.66;FR:6.16±0.95),with P<0.05.Meanwhile,in both groups,the TUGT and the MWS were improved after training(WVT=32.64±3.81 vs NWVT=39.56±3.68;WVT=12.73±2.26 vs NWVT=15.04±2.27,respectively),with P<0.05.The change in the WVT group(TUGT:17.49±1.88;MWS:6.79±0.81)was greater than that in the NWVT group(TUGT:10.76±1.42;MWS:4.84±0.58),with P<0.05.CONCLUSION The WVT could effectively improve the balance and walking function in stroke patients,which may be good for improving their quality of life.

Effects of 6-minute walk test on the QT dispersion in patients with congestive heart failure

Objective: To investigate the clinical value of QT dispersion (QTd) and the effects of 6-minute walk test (6-MWT) mimicking the patients' daily activities on QTd in patients with congestive heart failure (CHF).Methods: Twenty-eight CHF patients and 22 normal subjects participated these study, who all completed 6-MWT without developing severe arrhythmias.Before and after 6-MWT, standardized 12-lead surface ECGs were obtained to measure QTd and corrected QTd (QTcd).Results: Both before and after 6-MWT, the QTd and QTcd in CHF patients were longer than those in the controls (P<0.001), and QTd and QTcd after 6-MWT were significantly shorter than those before 6-MWT in CHF patients (P=0.007, and 0.018).There was no significant difference in the measurement in the control group.Conclusion: QTd and QTcd are longer in CHF patients than in normal subjects.Moderate exercise may improve the inhomogeneity of ventricular repolarization dispersion in CHF patients.

Application of Six-minute Walk Test in Heart Transplantation Patients

Objectives To analyze the six-minute walk test （6MWT） and gas exchange of 5 heart transplantation patients and to approach the variation tendency of exercise tolerance, oxygen uptake （ VO2 ） and heart rate chronotropic response. Methods 5 cases of heart transplantation patients （ age 25 - 52 years） were undertaken 6MWT 6 - 30 months after operation, synchronizing gas exchanging parameters were measured by wireless portable remote sensing K4B^2 gas analyzer, 51 normal controls were compared. Results The six-minute walk distance （6MWD） of 5 patients were （592.6 ± 26.7 ） m （558 - 625 ） m, the ascending tendency during exercise was slower, the maximum heart rates were 80% ± 6% of age-predicting maximal heart rate, lower than normal control （86%） ; the end point VO2/kg were （21.8 ± 1.4 ） mL/min · kg （ 19. 94 - 23.60） mL/min · kg. Conclusions The 6WMD and VO2 of 5 patients reached normal range, but the heart rate chronotropic response and VO2 ascending tendency were slower than those of normal controls.

A Study of Real-time Peak Oxygen Consumption and Six-minute Walk Test

Objectives To assess the relationship between peak oxygen consumption （PVO2） and the ambulation distance in six-minute walk test （6MWT）among the healthy subjects. Methods The 51 healthy subjects were recruited for the six-minute walk test. Data of pulmonary gas exchange breath by breath, such as VO2 , VCO2 were real-time measured with wireless remote sensing K4B2, so to study the relationship between peak oxygen uptake and the ambulation distance. Results It was noticed that there was a positive linear correlation between the ambulation distance and PVO2 （ r =0. 619, P 〈0. 001 ） in six-minute walk test. The regression equation was set up （ VO2/kg =0. 05D -6. 331, P 〈 0. 001 ）. PVO2 〉 PVCO2 ,R 〈 1 were found,which suggested that 6MWT was a test below anaerobic threshold. Conclusions There was a closely positive linear correlation between the ambulation distance and PVO2, which is safety, convenient and valuable for the evaluation of cardiopulmonary function and the treatment of cardiopulmonary rehabilitation.

The Impact of Footwear on Posture, Gait and Balance

Background: The objective of this study was to investigate the effects of footwear on posture and balance while walking. The types of footwear investigated in this study were open back shoes, commonly worn by hospitalized patients, and closed back shoes. Previous studies have shown that open back shoes, or slippers, increase the risk of falling (among elderly). We hypothesized that our findings would suggest that open back shoes negatively affect gait mechanics in healthy individuals. Methods: Healthy individuals (n = 12) participated in a walking test while wearing closed back shoes and open back shoes. The explanatory variables in this study were the analysis of gait, posture, and balance before and after walking. The objective variable was footwear (closed back shoes vs. open back shoes). A paired t-test was performed to detect significant differences between the two conditions. Results: Among the test items measured, we found a significant difference in minimum wide tilt angle and left-right differences in step length and intensity while walking between the conditions of closed back shoes and open back shoes. These results suggest that open back shoes could negatively impact posture and balance while walking, even in healthy subjects. Conclusion: It is imperative to improve patient awareness of the risk of falling. We believe that the inclusion of our findings in educational pamphlets and in-house notices could help improve patient awareness and more effectively prevent falls among patients.

Physical Activity and Body Composition Relate to Cardiorespiratory Fitness Independently in Young Adults with Down Syndrome

BACKGROUND： Persons with Down syndrome （DS） typically possess low cardiorespiratory fitness （CRF）, engage in low levels of physical activity （PA）, and display elevated obesity levels, but the association between these variables is not clear in persons with DS. METHOD： We investigated the relationships among measures of CRF, PA, and body composition in 30 young adults with DS （age： 21.3 ± 5.5 years） using a cross-sectional study design. RESULTS： Male participants presented on average with a BMI of 32.9 ± 10.0 kg/m2, a percent body fat of 22.2 ±13.0%, and a six-minute walk distance （6MWD） of 411.7 ± 66.3 m. Female participants presented on average with a BMI of 31.6 ± 13.5 kg/m2, a percent body fat of 26.7 ± 15.1%, and a six-minute walk distance （6MWD） of 360.4 ± 91.2 m. 6MWD shared a positive relationship with leisure time physical activity levels （r = 0.56, β = 1.488） and a negative relationship with body mass index （BMI; r = -0.49, β = -2.561）. No relationship between body composition and PA was found. CONCLUSIONS： It seems that higher PA levels and lower BMI relate to better CRF in young adults with DS. Physical activity and body composition appear to be unrelated in persons with DS.

Effects of an active lifestyle on the physical frailty of liver transplant candidates

BACKGROUND Liver transplantation is the most important therapeutic intervention for end-stage liver disease(ELD).The prioritization of these patients is based on the model for end-stage liver disease(MELD),which can successfully predict short-term mortality.However,despite its great validity and value,it cannot fully incorporate several comorbidities of liver disease,such as sarcopenia and physical frailty,variables that can sufficiently influence the survival of such patients.Subsequently,there is growing interest in the importance of physical frailty in regard to mortality in liver transplant candidates and recipients,as well as its role in improving their survival rates.AIM To evaluate the effects of an active lifestyle on physical frailty on liver transplant candidates.METHODS An observational study was performed within the facilities of the Department of Transplant Surgery of Aristotle University of Thessaloniki.Twenty liver transplant candidate patients from the waiting list of the department were included in the study.Patients that were bedridden,had recent cardiovascular incidents,or had required inpatient treatment for more than 5 d in the last 6 mo were excluded from the study.The following variables were evaluated:Activity level via the International Physical Activity Questionnaire(IPAQ);functional capacity via the 6-min walking test(6MWT)and cardiopulmonary exercise testing;and physical frailty via the Liver Frailty Index(LFI).RESULTS According to their responses in the IPAQ,patients were divided into the following two groups based on their activity level:Active group(A,10 patients);and sedentary group(S,10 patients).Comparing mean values of the recorded variables showed the following results:MELD(A:12.05±5.63 vs S:13.99±3.60;P>0.05);peak oxygen uptake(A:29.78±6.07 mL/kg/min vs S:18.11±3.39 mL/kg/min;P<0.001);anaerobic threshold(A:16.71±2.17 mL/kg/min vs S:13.96±1.45 mL/kg/min;P<0.01);6MWT(A:458.2±57.5 m vs S:324.7±55.8 m;P<0.001);and LFI(A:3.75±0.31 vs S:4.42±0.32;P<0.001).CONCLUSION An active lifestyle can be associated with better musculoskeletal and functional capacity,while simultaneously preventing the evolution of physical frailty in liver transplant candidates.This effect appears to be independent of the liver disease severity.

Normative Values of Cardio-Respiratory Endurance in Adults in Benin

Cardiorespiratory endurance is a determining factor in the assessment of the state of health of a person. Objective: To determine the reference values for cardiorespiratory endurance in Beninese adults. Methods: Prospective transversal study, with a descriptive and analytical aim. It was carried out on healthy adult subjects (18 to 50 years old), of Cotonou and Abomey cities, from October 2017 to May 2018, without clinically identifiable orthopedic, cardiorespiratory, osteoarticular or neuromotor impairment. These subjects performed three different cardio-respiratory endurance tests: The six-minute walk test (WT6), cycloergometer test (CT) and the step test (ST). Data processing and analysis were done using SPSS version 22 software. A linear regression model was used to establish the prediction equation of maximal oxygen uptake (VO2 max) with the WT6 data. The significance level chosen was 5%. Results: Subjects average age was 30.0 ± 9.8 years. It was especially men (54.20%), students (42.13%), with a normal corpulence (69.91%). At WT6, they walked 365 m to 798 m (557.1 ± 93.6 m) with extreme heart rates (EHR) of 67 to 189 (136.7 ± 19.0) beats per minute. At ST, the extreme powers developed were 2.7 watts/kg and 11.8 watts/kg (6.4 ± 1.8 watts/kg), with EHR of 99 to 204 (168.4 ± 15.4) beats per minute. The predictor equation of VO2 max by WT6 was function of the subject’s weight, age and sex (R = 0.73). Conclusion- Discussion: These normative values of cardio-respiratory endurance of Beninese subjects seem to be specific to them. An extension of the present study to a larger sample nevertheless seems desirable.

冠状动脉介入治疗对急性心肌梗死患者心功能的影响

目的探究冠状动脉介入治疗对急性心肌梗死患者心功能的影响。方法选取2020年7月-2023年6月我院收治的86例急性心肌梗死患者,根据不同治疗方式分成对照组和观察组,每组各43例。对照组接受常规治疗,观察组接受冠状动脉介入,对比两组治疗前后心功能指标[左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)、左心室射血分数(LVEF)]、6 min步行试验(6-minute walk test,6MWT)以及心脏不良事件发生率。结果治疗前,两组心功能标对比(P>0.05),治疗4周后,观察组LVEDVI、LVESVI下降较对照组明显,LVEF提升较对照组明显,具有显著差异(P<0.05);治疗1周后,两组6MWT对比无统计学意义(P>0.05),治疗2周、治疗4周后,两组6MWT逐渐提升,观察组较对照组提升明显,具有统计学意义(P<0.05);两组心脏不良事件发生率对比,观察组更低(P<0.05)。结论急性心肌梗死患者行冠状动脉介入治疗,能改善患者心功能,提高患者6MWT距,改善运动耐力,对于心脏不良事件发生率的降低有积极作用。

Relationship between 6-minute walk test and pulmonary function test in stable chronic obstructive pulmonary disease with different severities

Background The relationship between the 6-minute walk test （6MWT） and pulmonary function test in stable chronic obstructive pulmonary disease （COPD） remains unclear. We evaluate the correlation of 6MWT and spirometric parameters in stable COPD with different severities. 6MWT data assessed included three variables： the 6-minute walk distance （6MWD）, 6-minute walk work （6MWORK）, and pulse oxygen desaturation rate （SPO2%）. Methods 6MWT and pulmonary function test were assessed for 150 stable COPD patients with different severities. Means and standard deviations were calculated for the variables of interest. Analysis of variance was performed to compare means. Correlation coefficients were calculated for 6MWT data with the spirometric parameters and dyspnea Borg scale. Multiple stepwise regression analysis was used to screen pulmonary function-related predictors of 6MWT data. Results The three variables of 6MWT all varied as the severities of the disease. The 6MWD and 6MWORK both correlated with some spirometric parameters （positive or negative correlation; the absolute value of r ranging from 0.34 to 0.67; P 〈0.05） in severe and very severe patients, and the SPO2% correlated with the dyspnea Borg scale in four severities （t= -0.33, -0.34, -0.39, -0.53 respectively; P 〈0.05）. The 6MWD was correlated with the 6MWORK in four severities （r=0.56, 0.57, 0.72, 0.81 respectively, P 〈0.05）, and neither of them correlated with the SPO2%. The percent of predicted forced expiratory volume in 1 second （FEV1% predicted） and residual volume to total lung capacity ratio （RV/TLC） were predictors of the 6MWD, and the maximum voluntary ventilation （MW） was the predictor of the 6MWORK. Conclusions 6MWT correlated with the spirometric parameters in severe and very severe COPD patients. 6MWT may be used to monitor changes of pulmonary function in these patients.

Nine-hole Peg Test and Ten-meter Walk Test for Evaluating Functional Loss in Chinese Charcot-Marie-Tooth Disease

Background：The 9-hole peg test （9-HPT） and 10-meter walk test （10-MWT） are commonly used to test finger motor function and walking ability.The aim of this present study was to investigate the efficacy of these tests for evaluating functional loss in Chinese Charcot-Marie-Tooth （CMT） disease.Methods：Thirty-four Chinese CMT patients （CMT group） from August 2015 to December 2016 were evaluated with 9-HPT,10-MWT,CMT disease examination score,overall neuropathy limitation scale （ONLS）,functional disability score,and Berg Balance Scale （BBS）.Thirty-five age-and gender-matched healthy controls （control group） were also included in the study.Student＇s nonpaired or paired t-test were performed to compare data between two independent or related groups,respectively.The Pearson test was used to examine the correlations between recorded parameters.Results：The mean 9-HPT completion time in the dominant hand of CMT patients was significantly slower than that in the healthy controls （29.60 ± 11.89 s vs.19.58 ± 3.45 s;t =-4.728,P 〈 0.001）.Women with CMT completed the 9-HPT significantly faster than men with CMT （dominant hand：24.74 ± 7.93 s vs.33.01 ± 13.14 s,t =2.097,P =0.044）.The gait speed of the average self-selected velocity and the average fast-velocity assessed using 10-MWT for CMT patients were significantly slower than those in the control group （1.03 ± 0.18 m/s vs.1.44 ± 0.17 m/s,t =9.333,P 〈 0.001;1.31 ± 0.30 m/s vs.1.91 ± 0.25 m/s,t =8.853,P 〈 0.00 1,respectively）.There was no difference in gait speed between men and women.Both 9-HPT and 10-MWT were significantly correlated with the ONLS,functional disability score,and BBS （P 〈 0.05 for all）.Conclusion：The 9-HPT and 10-MWT might be useful for functional assessment in Chinese patients with CMT.

Clinical study on long-snake moxibustion plus Western medicine in treating chronic heart failure due to heart-kidney yang deficiency

Objective To observe the clinical efficacy of long-snake moxibustion plus Western medicine for chronic heart failure due to heart-kidney yang deficiency.Methods A total of 80 patients were randomized into a control group and an observation group,with 40 cases in each group.The control group was treated with routine Western medicine,and the observation group was treated with long-snake moxibustion therapy on the basis of routine Western medicine.Left ventricular ejection fraction(LVEF),stroke volume(SV)and left ventricular end-diastolic diameter(LVEDd)were measured before and after treatment,and the heart function was assessed.The serum brain natriuretic peptide(BNP)level was measured,the 6 min walking distance was recorded,and the Minnesota living with heart failure questionnaire(MLHFQ)was assessed and scored.The serum galectin-3(Gal-3)and soluble growth stimulation expressed gene 2(sST2)protein levels were measured.Clinical efficacy was evaluated after treatment.Results The total effective rate of the observation group was higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,LVEF and LVEDd in both groups were significantly improved(all P<0.05),and LVEF,SV and LVEDd in the observation group were superior to those in the control group(all P<0.05).The heart function classification in both groups were improved after treatment(both P<0.05),and the heart function classification in the observation group was superior to that in the control group(P<0.05).The serum BNP level in both groups decreased(both P<0.05),and the serum BNP level in the observation group was lower than that in the control group(P<0.05).The 6 min walking distance and MLHFQ scores in both groups were improved(all P<0.05),and the 6 min walking distance and MLHFQ score in the observation group were superior to those in the control group(both P<0.05).The serum Gal-3 and sST2 levels in the observation group decreased significantly(both P<0.05),and all lower than those in the control group(both P<0.05).Conclusion Long-snake moxibustion plus Western medicine has significant efficacy in treating chronic heart failure due to heart-kidney yang deficiency;it can improve heart function,reduce the serum BNP level,and improve the exercise endurance and quality of life in the patients.This may be related to the down-regulation of serum Gal-3 and sST2 levels.

Effects of Qizhukangxian granules on idiopathic pulmonary fibrosis:a randomized,double blind,placebo-controlled and multicenter clinical pilot trial

OBJECTIVE:To evaluate the effects of Qizhukangxian granules(QG)on idiopathic pulmonary fibrosis(IPF).METHODS:This is a randomized,double blind,placebo-controlled and multicenter clinical pilot trial.Six medical centers in Tianjin,China,participated in the study.A total of 120 IPF patients were enrolled and randomized into two groups,with 60 patients in each group.The treatment group was treated with QG,while the control group received a Qizhukangxian placebo.The pharmacological treatment lasted for 48 weeks from the enrollment date.The indexes of patients were recorded on the admission day and at the end of the 24th and 48th weeks.Data were analyzed to study the effects of QG;forced vital capacity,change in forced vital capacity and maximal 6-min walk test(6MWT)distance were the primary endpoints.Secondary endpoints were percentage of patients with episodes of acute exacerbation of IPF,pulmonary function,changes in pulse oxygen saturation during the 6MWT,dyspnea score,St.George's respiratory questionnaire score,arterial blood gas analyses and the total Traditional Chinese Medicine symptom pattern score.RESULTS:After 24 weeks of treatment,QG showed greater efficacy than the placebo in certain parameters,including the dyspnea score,Traditional Chinese Medicine symptom pattern score and some indicators in the St.George's respiratory questionnaire score.Analysis of the indexes obtained from all patients at the end of the 48th week showed that the therapeutic effects in the treatment group were significantly better than those in the control group because remarkable differences were observed in most of the primary and secondary endpoints between the two groups,except for the maximal distance of the 6MWT and arterial blood gas analyses.No adverse reaction was observed in either group during the 48-week trial treatment period.CONCLUSION:QG could effectively treat IPF patients by ameliorating pulmonary function,improving the quality of life and lowering the percentage of acute exacerbations.